Zika Virus

Zika is a virus that is spread mostly by mosquitoes. A pregnant mother can pass it to her baby during pregnancy or around the time of birth. It can spread through sexual contact. There have also been reports that the virus has spread through blood transfusions. There have been outbreaks of Zika virus in the United States, Africa, Southeast Asia, the Pacific Islands, parts of the Caribbean, and Central and South America.

Most people who get the virus do not get sick. One in five people do get symptoms, which can include a fever, rash, joint pain, and conjunctivitis (pinkeye). Symptoms are usually mild, and start 2 to 7 days after being bitten by an infected mosquito.

A blood test can tell whether you have the infection. There are no vaccines or medicines to treat it. Drinking lots of fluids, resting, and taking acetaminophen might help.

Zika can cause microcephaly (a serious birth defect of the brain) and other problems in babies whose mothers were infected while pregnant. The Centers for Disease Control and Prevention recommends that pregnant women do not travel to areas where there is a Zika virus outbreak. If you do decide to travel, first talk to your doctor. You should also be careful to prevent mosquito bites:

  • Use insect repellent
  • Wear clothes that cover your arms, legs, and feet
  • Stay in places that have air conditioning or that use window and door screens

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Travel to an area where Zika is present is the main risk factor for the virus.

It is mainly transmitted through mosquito bites, but it can also be passed on:

  • From a pregnant woman to her fetus
  • Through sexual contact
  • Possibly, through a blood transfusion

To date, there have been no known transmissions of the virus from mother to infant during breast-feeding.

After a person has had the virus, they are protected from it in the future.

A woman who is pregnant should be particularly careful to avoid mosquito bites if she is living in or traveling to a country where Zika is present. It may be advisable to avoid travel to certain places during pregnancy.

The Centers for Disease Control and Prevention (CDC) issue travel warnings about Zika transmission.

These are mainly the tropical regions of:

  • Central and South America
  • Caribbean
  • Oceania
  • North America
  • Africa
  • Asia

Travelers should refer to the CDC website for updates.

Zika virus may be symptomless, or the symptoms can be vague and mild. They last for up to a week.

Initial symptoms include:

  • fever
  • rash
  • joint pain
  • conjunctivitis, or red eyes
  • muscle pain
  • headache
  • pain behind the eyes
  • vomiting

Infection with the Zika virus is rarely severe enough to warrant hospitalization, and it is rarer still for an individual to die as a result.

However, complications of Zika can be devastating, especially if a woman contracts the virus while she is pregnant.

It can cause a brain defect known as microcephaly in the unborn child. The brain and head of the newborn will be smaller in size than is usual. Loss of pregnancy, stillbirth, and other congenital disabilities are also more likely.

During the recent outbreak in Brazil, there was a 10-fold increase in newborns with microcephaly after October 2015, compared with previous years.

There have also been reports of people developing Guillain-Barré syndrome following a Zika virus infection. Guillain-Barré syndrome is a rare but serious autoimmune disorder that affects the central nervous system.

Your doctor will likely ask about your medical and travel history. Be sure to describe international trips in detail, including the countries you and your sexual partner have visited and the dates, as well as any contact you may have had with mosquitoes.

Talk to your doctor about which tests for Zika virus — or similar diseases such as dengue or chikungunya viruses, which are spread by the same type of mosquitoes — are available in your area.

A pregnant woman with no symptoms of Zika virus infection with a history of recent travel to an area with active Zika virus transmission can be offered testing two to 12 weeks after her return.

Following positive, inconclusive or negative test results, care providers may:

  • Perform an ultrasound to detect microcephaly or other abnormalities of the brain
  • Offer to take a sample of amniotic fluid using a hollow needle inserted into the uterus (amniocentesis) to screen for Zika virus

Currently, there is no treatment for Zika.

A person with symptoms should:

  • rest
  • increase fluid intake to prevent dehydration
  • take over-the-counter (OTC) pain killers to relieve pain and fever

The CDC advise against using aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) until a diagnosis of dengue has been ruled out in those at risk due to the risk of hemorrhage.

The CDC also advise that pregnant women who are diagnosed with Zika should be considered for the monitoring of fetal growth and anatomy program every 3 to 4 weeks.

They also recommend seeing a doctor who specializes in pregnancy management and either infectious disease or maternal-fetal medicine.

There is no vaccine to protect against Zika virus disease.

The CDC recommends all pregnant women avoid traveling to areas where there is an outbreak of Zika virus. If you are trying to become pregnant, talk to your doctor about any upcoming travel plans and the risk of getting infected with Zika virus.

If you have a male partner who lives in or has traveled to an area where there is an outbreak of Zika virus, the CDC recommends abstaining from sex during pregnancy or using a condom during sexual contact.

If you are living or traveling in tropical areas where Zika virus is known to be, these tips may help reduce your risk of mosquito bites:

  • Stay in air-conditioned or well-screened housing. The mosquitoes that carry the Zika virus are most active from dawn to dusk, but they can also bite at night. Consider sleeping under a mosquito bed net, especially if you are outside.
  • Wear protective clothing. When you go into mosquito-infested areas, wear a long-sleeved shirt, long pants, socks and shoes.
  • Use mosquito repellent. Permethrin can be applied to your clothing, shoes, camping gear and bed netting. You also can buy clothing made with permethrin already in it. For your skin, use a repellent containing at least a 10 percent concentration of DEET.

When used as directed, insect repellents that are registered with the Environmental Protection Agency (EPA) are proven safe and effective for pregnant and breast-feeding women.

  • Reduce mosquito habitat. The mosquitoes that carry the Zika virus typically live in and around houses, breeding in standing water that can collect in such things as animal dishes, flower pots and used automobile tires. Reduce the breeding habitat to lower mosquito populations.

Zika virus transmitted through blood transfusion

All blood donations are now screened for Zika virus. To further reduce the risk of transmitting Zika virus through blood transfusion in areas where there are no active Zika virus outbreaks, the Food and Drug Administration recommends not donating blood for four weeks if you:

  • Have a history of Zika virus infection
  • Traveled or lived in an area with active Zika virus transmission
  • Have symptoms that are suggestive of Zika virus infection within two weeks of travel from an area with Zika virus
  • Have had sexual contact with a male partner who has been diagnosed with Zika virus infection
  • Have had sexual contact with a male partner who has traveled or lived in an area with active Zika virus transmission in the past three months

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